National Healthcare Quality and Disparities Report
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AHRQ Research Studies
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Research Studies is a compilation of published research articles funded by AHRQ or authored by AHRQ researchers.
Results
1 to 25 of 81 Research Studies DisplayedPerl J, Fuller DS, Boudville N
Optimizing peritoneal dialysis-associated peritonitis prevention in the United States: from standardized peritoneal dialysis-associated peritonitis reporting and beyond.
Peritoneal dialysis (PD)-associated peritonitis is the leading cause of permanent transition to hemodialysis among patients receiving PD. Optimizing the prevention of peritonitis in the United States will first require standardization of peritonitis definitions, key data elements, and outcomes in an effort to facilitate nationwide reporting. In this paper, the investigators highlighted considerations and challenges in developing standardized definitions and implementation of national reporting of peritonitis rates by PD facilities.
AHRQ-funded; HS025756.
Citation: Perl J, Fuller DS, Boudville N .
Optimizing peritoneal dialysis-associated peritonitis prevention in the United States: from standardized peritoneal dialysis-associated peritonitis reporting and beyond.
Clin J Am Soc Nephrol 2020 Dec 31;16(1):154-61. doi: 10.2215/cjn.11280919..
Keywords: Kidney Disease and Health, Quality Improvement, Quality of Care
Groetzinger LM, Rivosecchi RM, McVerry BJ
A quality improvement evaluation of a primary as-needed light sedation protocol in mechanically ventilated adults.
This study assessed outcomes of using a light-sedation protocol as needed compared to the more usual continuous infusion sedation in mechanically ventilated adults in medical intensive care units (ICUs). This retrospective review compared patients who received the as needed sedation protocol to similar patients treated initially with continuous infusion sedation at a 32-bed medical ICU in a large academic center. Over a 2-year period, 254 total mechanically ventilated patients were evaluated. Of the evaluable patients, 114 received the prioritizing as-needed sedation protocol, and 140 received the continuous infusion approach. In the as-needed group, 42% of patients never received continuous infusion sedation. The group also received significantly less opioid, propofol, and benzodiazepine; and experienced less delirium, shorter duration of mechanical ventilation, and shorter ICU length of stay compared to the continuous infusion sedation group.
AHRQ-funded; HS025455.
Citation: Groetzinger LM, Rivosecchi RM, McVerry BJ .
A quality improvement evaluation of a primary as-needed light sedation protocol in mechanically ventilated adults.
Crit Care Explor 2020 Dec;2(12):e0264. doi: 10.1097/cce.0000000000000264..
Keywords: Quality Improvement, Quality of Care, Intensive Care Unit (ICU), Critical Care, Implementation
Griffey RT, Schneider RM, Sharp BR
Description and yield of current quality and safety review in selected US academic emergency departments.
This study examined the impact of current quality and safety reviews used in US academic emergency departments (EDs). The authors hypothesized that current protocols are decades old and inefficient with low yield for identifying patient harm. They conducted a prospective observational study at five academic EDs for a 12-month procedure. Sites used the Institute for Healthcare Improvement’s definition in defining an adverse event and a modified National Coordinating Council for Medication Error Reporting and Prevention (MERP) Index for severity grading of events. They reviewed a total of 4735 cases and identified 381 events, of which 287 were near-misses, and 94 had adverse events (AEs). The overall AE rate was 1.99% (1.24-3.47%) across all sites. Quality concern rate (events without harms) was 6.06% (5.42-6.78%). Forty-seven percent of cases used 72 hour returns as their referral source but with only a 0.81% yield in identifying harm. Other referral sources also had similar low yields. External referrals in the 94 AE cases accounted for 41.49% of cases. The authors concluded that new approaches to quality and safety review in the ED are needed to optimize yield and efficiency for identifying harms and areas for improvement.
AHRQ-funded; HS025052.
Citation: Griffey RT, Schneider RM, Sharp BR .
Description and yield of current quality and safety review in selected US academic emergency departments.
J Patient Saf 2020 Dec;16(4):e245-e49. doi: 10.1097/pts.0000000000000379..
Keywords: Emergency Department, Patient Safety, Quality Improvement, Quality of Care, Provider Performance
Liu FF, Lew A, Andes E
Implementation strategies for depression and anxiety screening in a pediatric cystic fibrosis center: a quality improvement project.
The objective of this study was to share key strategies that led to successful mental health screening (MHS) implementation in one pediatric cystic fibrosis center and to report implementation and screening outcomes. Results showed that leveraging coproduction to address stakeholder needs led to successful implementation of a sustainable MHS process.
AHRQ-funded; HS026393.
Citation: Liu FF, Lew A, Andes E .
Implementation strategies for depression and anxiety screening in a pediatric cystic fibrosis center: a quality improvement project.
Pediatr Pulmonol 2020 Dec;55(12):3328-36. doi: 10.1002/ppul.24951..
Keywords: Children/Adolescents, Respiratory Conditions, Chronic Conditions, Depression, Anxiety, Behavioral Health, Screening, Implementation, Quality Improvement, Quality of Care, Diagnostic Safety and Quality
Qureshi N, Quigley DD, Hays RD
Nationwide qualitative study of practice leader perspectives on what it takes to transform into a patient-centered medical home.
The purpose of this study was to examine reasons practices obtained and maintained patient-centered medical home (PCMH) recognition and what resources were needed. The investigators concluded that PCMH efforts necessitated support and assistance to frontline, on-site practice leaders leading care delivery changes. They suggested that change efforts should include financial incentives (e.g., direct payment or additional reimbursement), leadership direction and support, and internal or external staff with experience with the PCMH application process, implementation changes, and QI expertise in monitoring process and outcome data.
AHRQ-funded; HS016980.
Citation: Qureshi N, Quigley DD, Hays RD .
Nationwide qualitative study of practice leader perspectives on what it takes to transform into a patient-centered medical home.
J Gen Intern Med 2020 Dec;35(12):3501-09. doi: 10.1007/s11606-020-06052-1..
Keywords: Patient-Centered Healthcare, Primary Care: Models of Care, Primary Care, Quality Improvement, Quality of Care, Healthcare Delivery
Quigley DD, Qureshi N, Masarweh LA
Practice leaders report targeting several types of changes in care experienced by patients during patient-centered medical home transformation.
This study looked at how primary care practices implemented changes during the transition to becoming a patient-centered medical home (PCMH). The authors examined 105 primary care practice leader experiences during PCMH transformation using semi-structured interviews. Practices most commonly targeted changes in care coordination (30%), access to care (25%), and provider communication (24%). Reported areas for PCMH transformation were measured by Clinician & Group CAHPS, PCMH CAHPS, or supplemental CAHPS survey items, including team-based care (35%), providing more on-site services (28%), care management (22%), patient-centered culture (18%), and chronic condition health education (13%). Many PCMH changes are captured by CAHPS survey items, but some are not.
AHRQ-funded; HS025920.
Citation: Quigley DD, Qureshi N, Masarweh LA .
Practice leaders report targeting several types of changes in care experienced by patients during patient-centered medical home transformation.
J Patient Exp 2020 Dec;7(6):1509-18. doi: 10.1177/2374373520934231..
Keywords: Consumer Assessment of Healthcare Providers and Systems (CAHPS), Primary Care: Models of Care, Primary Care, Patient-Centered Healthcare, Patient Experience, Care Coordination, Quality Improvement, Quality of Care, Implementation
Brajcich BC, Bentrem DJ, Yang AD
Short-term risk of performing concurrent procedures with hepatic artery infusion pump placement.
This study’s objective was to characterize the short-term outcomes of concurrent surgery with hepatic artery infusion pump (HAIP) placement using data from the 2005-2017 ACS NSQIP dataset. Findings showed that HAIP placement is not associated with additional morbidity when performed with hepatic and/or colorectal surgery. Decisions regarding HAIP placement should consider the risks of concurrent operations as well as patient- and disease-specific factors.
AHRQ-funded; HS026385.
Citation: Brajcich BC, Bentrem DJ, Yang AD .
Short-term risk of performing concurrent procedures with hepatic artery infusion pump placement.
Ann Surg Oncol 2020 Dec;27(13):5098-106. doi: 10.1245/s10434-020-08938-0..
Keywords: Quality Improvement, Quality of Care, Surgery, Risk, Cancer, Outcomes
Harder VS, Shaw JS, McCulloch CE
Statewide asthma learning collaborative participation and asthma-related emergency department use.
This study looked at outcomes from participation of pediatric practices in a quality improvement (QI) collaborative to decrease asthma-related emergency department (ED) visits. A statewide network of practices participated in the collaborative from 2015 to 2016. Asthma-related ED visit rates per 100 child-years for children ages 3 to 21 was evaluated using the state’s all-payer claims databases. The authors found that in the postintervention year (2017) participating practices’ ED visit rate decreased by 5.8 per 100 child-years, compared to an increase of 1.8 per 100 child-years in non-participating practices. There were no statistically significant differences in asthma-related ED visit rates during 2016, which indicated that it took some time for QI elements to be successfully implemented in pediatric practices.
AHRQ-funded; HS025297.
Citation: Harder VS, Shaw JS, McCulloch CE .
Statewide asthma learning collaborative participation and asthma-related emergency department use.
Pediatrics 2020 Dec;146(6):e20200213. doi: 10.1542/peds.2020-0213..
Keywords: Children/Adolescents, Asthma, Emergency Department, Quality Improvement, Quality of Care, Primary Care, Guidelines
Hu QL, Grant MC, Hornor MA
Technical evidence review for emergency major abdominal operation conducted for the AHRQ Safety Program for Improving Surgical Care and Recovery.
This technical evidence review focuses on the use of enhanced recovery pathways (ERPs) for emergency major abdominal surgery conducted for the AHRQ Safety Program for Improving Surgical Care and Recovery (ISCR). This national ERP initiative is funded by AHRQ and implemented in 2017 through a collaboration with American College of Surgeons, and Johns Hopkins Medicine Armstrong Institute for Patient Safety and Quality. Five common emergency general surgery (EGS) procedures were focused on: perforated peptic ulcer repair, colectomy, lysis of adhesions, small bowel resection, and exploratory laparotomy. The authors identified seventeen candidate components for emergency major abdominal ERP. The components span the continuum of care from preoperative setting to hospital discharge. For every component they conducted a systematic literature review to find relevant studies. Each component was examined for rationale, evidence, and summary and recommendations. Many were supported by evidence and guidelines specific to their particular operation. Key gaps in literature were highlighted, specifically lack of evidence specific to these operations across many ERP processes.
AHRQ-funded; 233201500020I.
Citation: Hu QL, Grant MC, Hornor MA .
Technical evidence review for emergency major abdominal operation conducted for the AHRQ Safety Program for Improving Surgical Care and Recovery.
J Am Coll Surg 2020 Dec;231(6):743-64.e5. doi: 10.1016/j.jamcollsurg.2020.08.772..
Keywords: Evidence-Based Practice, Surgery, Patient Safety, Quality Improvement, Quality of Care, Patient-Centered Outcomes Research
Griffey RT, Schneider RM, Todorov AA
The emergency department trigger tool: validation and testing to optimize yield.
Researchers validated the emergency department trigger tool (EDTT) in an independent sample and compared record selection approaches to optimize yield for quality improvement. In this single-site study of the EDTT, they observed high levels of validity in trigger selection, yield, and representativeness of adverse events, with yields that are superior to estimates for traditional approaches to adverse event detection. Record selection using weighted triggers outperformed a trigger count threshold approach and far outperformed random sampling from records with at least one trigger. They concluded that the EDTT is a promising efficient and high-yield approach for detecting all-cause harm to guide quality improvement efforts in the emergency department.
AHRQ-funded; HS025052.
Citation: Griffey RT, Schneider RM, Todorov AA .
The emergency department trigger tool: validation and testing to optimize yield.
Acad Emerg Med 2020 Dec;27(12):1279-90. doi: 10.1111/acem.14101..
Keywords: Emergency Department, Electronic Health Records (EHRs), Health Information Technology (HIT), Medical Errors, Adverse Events, Patient Safety, Quality Improvement, Quality of Care
Aysola J, Xu C, Huo H
The relationships between patient experience and quality and utilization of primary care services.
This study examined the associations between visit-triggered patient-reported experience measures and both quality of care measures and the number of missed primary care appointments. A cross-sectional analysis of 8355 primary care patients from 22 primary care practices was conducted. Outcomes measured included: smoking cessation discussion, diabetes eye examination referral, mammography, colonoscopy screening, current smoking status, diabetes control hemoglobin A1c, blood pressure control, cholesterol control LDL among patients with diabetes, and visit no shows 2 and 5 years after the index visit. The authors found that patient experience can be an important stand-alone metric of care quality, although it may not relate to clinical outcomes or process measures in the outpatient setting.
AHRQ-funded; HS021706.
Citation: Aysola J, Xu C, Huo H .
The relationships between patient experience and quality and utilization of primary care services.
J Patient Exp 2020 Dec;7(6):1678-84. doi: 10.1177/2374373520924190..
Keywords: Patient Experience, Primary Care, Primary Care: Models of Care, Patient-Centered Healthcare, Quality Improvement, Quality of Care
Luo B, McLoone M, Rasooly IR
Analysis: protocol for a new method to measure physiologic monitor alarm responsiveness.
A team of researchers including biomedical engineers, human factors engineers, information technology specialists, nurses, physicians, facilitators from a hospital’s simulation center, clinical informaticians, and hospital administrative leadership worked with three units at a pediatric hospital to design and conduct simulations on newly implemented monitoring technology that will be used for patient critical alarms. The system was tested using a simulation with existing hospital technology to transmit an unambiguously critical alarm that appeared to originate from an actual patient to the nurse’s mobile device, with discreet observers measuring responses.
AHRQ-funded; HS026620.
Citation: Luo B, McLoone M, Rasooly IR .
Analysis: protocol for a new method to measure physiologic monitor alarm responsiveness.
Biomed Instrum Technol 2020 Nov/Dec;54(6):389-96. doi: 10.2345/0899-8205-54.6.389..
Keywords: Children/Adolescents, Hospitals, Simulation, Quality Improvement, Quality of Care, Patient Safety, Health Information Technology (HIT)
Hernandez AV, Roman YM, White CM
Developing criteria and associated instructions for consistent and useful quality improvement study data extraction for health systems.
This paper describes AHRQ’s efforts to collate and assess quality improvement studies to support learning health systems (LHS). The authors identified quality improvement studies and evaluated the consistency of data extraction from two experienced independent reviewers at three time points: baseline, first revision, and final revision. Six investigators looked at the data extracted by the independent reviewers and determined the extent of similarity on a scale of 0 to 10. Two LHS participants were then asked to assess the relative value of their criteria. The consistency of extraction improved from a mean 1.17 score at baseline to 6.07 at first revision, and 6.81 at the final revision. There was not a significant improvement from the first to final revision. However, the LHS participants rated the value of these ratings a 9 and a 6, demonstrating that there is value in developing criteria.
AHRQ-funded; 290201500012I.
Citation: Hernandez AV, Roman YM, White CM .
Developing criteria and associated instructions for consistent and useful quality improvement study data extraction for health systems.
J Gen Intern Med 2020 Nov;35(Suppl 2):802-07. doi: 10.1007/s11606-020-06098-1..
Keywords: Quality Improvement, Quality of Care, Learning Health Systems, Health Systems, Health Services Research (HSR), Research Methodologies
Hu QL, Fischer CP, Wescott AB
Evidence review for the American College of Surgeons Quality Verification part I: building quality and safety resources and infrastructure.
The goal of this review was to synthesize the evidence supporting the first 4 of 12 American College of Surgeons (ACS) Quality Verification Program core principles of building quality and safety resources and infrastructure. Findings showed that, despite heterogeneous study design and lack of randomized controlled trials, the available literature supports the importance of committed top-level hospital leadership, mid-level leadership, and committee dedicated to surgical quality and culture of safety and high reliability. In conclusion, adequate resources and infrastructure integral to the ACS Quality Verification Program are critical to achieving safe and high-quality surgical outcomes.
AHRQ-funded; 233201500020I.
Citation: Hu QL, Fischer CP, Wescott AB .
Evidence review for the American College of Surgeons Quality Verification part I: building quality and safety resources and infrastructure.
J Am Coll Surg 2020 Nov;231(5):557-69.e1. doi: 10.1016/j.jamcollsurg.2020.08.758..
Keywords: Quality Improvement, Quality of Care, Patient Safety, Surgery, Evidence-Based Practice
Fernald DH, Mullen R,, Hall T
Exemplary practices in cardiovascular care: results on clinical quality measures from the EvidenceNOW Southwest Cooperative.
The authors identified practice characteristics associated with high performance on four cardiovascular disease cardiovascular clinical quality measures (CQMs). They found that multiple strategies - registries, prompts and protocols, patient self-management support, and patient-team partnership activities - were associated with delivering high-quality cardiovascular care over time, measured by CQMs.
AHRQ-funded; HS023904.
Citation: Fernald DH, Mullen R,, Hall T .
Exemplary practices in cardiovascular care: results on clinical quality measures from the EvidenceNOW Southwest Cooperative.
J Gen Intern Med 2020 Nov;35(11):3197-204. doi: 10.1007/s11606-020-06094-5..
Keywords: Cardiovascular Conditions, Quality Indicators (QIs), Quality Measures, Quality Improvement, Quality of Care, Evidence-Based Practice, Patient-Centered Outcomes Research, Primary Care
Abramsohn E, DePumpo M, Boyd K
Implementation of community-based resource referrals for cardiovascular disease self-management.
Investigators described primary care practices' implementation of CommunityRx-H3. They found that practice facilitators were increasingly being utilized by primary care practices to support quality improvement interventions and could also play an important role in implementation science. Their study yielded insights to improve implementation of community resource referral solutions to support primary care cardiovascular disease prevention efforts.
AHRQ-funded; HS023921.
Citation: Abramsohn E, DePumpo M, Boyd K .
Implementation of community-based resource referrals for cardiovascular disease self-management.
Ann Fam Med 2020 Nov;18(6):486-95. doi: 10.1370/afm.2583..
Keywords: Cardiovascular Conditions, Patient Self-Management, Primary Care, Quality Improvement, Quality of Care, Implementation
Carroll AR, Johnson DP
Know it when you see it: identifying and using special cause variation for quality improvement.
This article concerning an article that appears in the same issue discusses statistical process control charts. The authors conclude that by understanding the rules of special cause variation and applying them to data in real time, teams will be provided with information that will inform hypotheses testing, bolster knowledge about a system, and ultimately accelerate improvement work.
AHRQ-funded; HS026122.
Citation: Carroll AR, Johnson DP .
Know it when you see it: identifying and using special cause variation for quality improvement.
Hosp Pediatr 2020 Nov;10(11):e8-e10. doi: 10.1542/hpeds.2020-002303..
Keywords: Quality Improvement, Quality of Care, Health Services Research (HSR)
Mangrum R, Stewart MD, Gifford DR
Omissions of care in nursing homes: a uniform definition for research and quality improvement.
The goal of this study was to create a uniform definition of omission of care in US nursing homes. Lack of a uniform definition has made efforts to prevent them challenging. Subject matter experts and a broad range of nursing home stakeholders were brought together in iterative rounds of engagement to identify key concepts and aspects of omissions of care and develop a consensus-based definition. The concise definition decided on was: “Omissions of care in nursing homes encompass situations when care–either clinical or nonclinical–is not provided for a resident and results in additional monitoring or intervention or increases the risk of an undesirable or adverse physical, emotional, or psychosocial outcome for the resident."
AHRQ-funded; 233201500014I.
Citation: Mangrum R, Stewart MD, Gifford DR .
Omissions of care in nursing homes: a uniform definition for research and quality improvement.
J Am Med Dir Assoc 2020 Nov;21(11):1587-91.e2. doi: 10.1016/j.jamda.2020.08.016..
Keywords: Elderly, Nursing Homes, Long-Term Care, Quality Improvement, Quality of Care, Medical Errors, Adverse Events, Patient Safety, Risk, Patient-Centered Outcomes Research
Rauscher GH, Tossas-Milligan K, Macarol T
Trends in attaining mammography quality benchmarks with repeated participation in a quality measurement program: going beyond the mammography quality standards act to address breast cancer disparities.
The Mammography Quality Standards Act requires that mammography facilities conduct audits, but there are no specifications on the metrics to be measured. In this study, the authors present trends from the first 5 years of data collection to examine whether continued participation in this quality improvement program was associated with an increase in the number of benchmarks met for breast cancer screening.
AHRQ-funded; HS018366.
Citation: Rauscher GH, Tossas-Milligan K, Macarol T .
Trends in attaining mammography quality benchmarks with repeated participation in a quality measurement program: going beyond the mammography quality standards act to address breast cancer disparities.
J Am Coll Radiol 2020 Nov;17(11):1420-28. doi: 10.1016/j.jacr.2020.07.019..
Keywords: Cancer: Breast Cancer, Cancer, Women, Screening, Quality Measures, Quality Improvement, Quality of Care, Diagnostic Safety and Quality
Aguirre A, Trupin L, Margaretten M
Using process improvement and systems redesign to improve rheumatology care quality in a safety net clinic.
Researchers sought to develop and evaluate interventions to improve quality of care in four priority areas in an urban safety net adult rheumatology clinic serving a racially/ethnically and socioeconomically diverse patient population. Clinical processes were redesigned to achieve pre-specified benchmarks in the following four areas: 13-valent pneumococcal conjugate vaccine (PCV13) administered to immunocompromised patients; Clinical Disease Activity Index (CDAI) disease activity monitoring for patients with rheumatoid arthritis; latent tuberculosis infection (LTBI) screening for new biologic users with rheumatoid arthritis; reproductive health counseling among women receiving potentially teratogenic medications. Through an interprofessional approach, the researchers achieved durable improvements in key rheumatology quality measures largely by enhancing workflow, engaging non-physician providers, and managing practice variation.
AHRQ-funded; HS024412; HS025638.
Citation: Aguirre A, Trupin L, Margaretten M .
Using process improvement and systems redesign to improve rheumatology care quality in a safety net clinic.
J Rheumatol 2020 Nov;47(11):1712-20. doi: 10.3899/jrheum.190472..
Keywords: Urban Health, Rural/Inner-City Residents, Quality Improvement, Quality of Care, Healthcare Delivery
Merkow RP, Shan Y, Gupta AR
A comprehensive estimation of the costs of 30-day postoperative complications using actual costs from multiple, diverse hospitals.
The objective of this study was to define the cost of individual, 30-day postoperative complications using robust cost data from a diverse group of hospitals. Findings showed that the three complications associated with the highest independent adjusted cost per event were prolonged ventilation, unplanned intubation, and renal failure, while the three complications associated with the lowest independent adjusted cost per event were urinary tract infection, superficial surgical site infection and venous thromboembolism. The authors indicated that the actual hospital costs of complications were estimated using cost data from four diverse hospitals, and that these data can be used by hospitals to estimate the financial benefit of reducing surgical complications.
AHRQ-funded; HS024516; HS026385.
Citation: Merkow RP, Shan Y, Gupta AR .
A comprehensive estimation of the costs of 30-day postoperative complications using actual costs from multiple, diverse hospitals.
The objective of this study was to define the cost of individual, 30-day postoperative .
Keywords: Surgery, Healthcare Costs, Adverse Events, Quality Improvement, Quality of Care
Schlesinger M, Grob R, Shaller D
A rigorous approach to large-scale elicitation and analysis of patient narratives.
Patient narratives have emerged as promising vehicles for making health care more responsive by helping clinicians to better understand their patients' expectations, perceptions, or concerns and encouraging consumers to engage with information about quality. In this article, the investigators offer the first empirical test of the proposition that patient narratives can be elicited rigorously and reliably using a five-question protocol that can be incorporated into large-scale patient experience surveys.
AHRQ-funded; HS021858; HS016978; HS016980; HS025920.
Citation: Schlesinger M, Grob R, Shaller D .
A rigorous approach to large-scale elicitation and analysis of patient narratives.
Med Care Res Rev 2020 Oct;77(5):416-27. doi: 10.1177/1077558718803859..
Keywords: Patient Experience, Quality Improvement, Quality of Care
Schlick CJR, Khorfan R, Odell DD
Adequate lymphadenectomy as a quality measure in esophageal cancer: is there an association with treatment approach?
In this study, the authors’ objectives were to (1) explore trends in adequate lymphadenectomy rates over time; (2) evaluate unadjusted lymphadenectomy yield by treatment characteristics; and (3) identify independent factors associated with adequate lymphadenectomy. The investigators found that despite increases over time, only 50% of patients underwent adequate lymphadenectomy during esophageal cancer resection. They also found that adequate lymphadenectomy was not associated with neoadjuvant therapy.
AHRQ-funded; HS026385.
Citation: Schlick CJR, Khorfan R, Odell DD .
Adequate lymphadenectomy as a quality measure in esophageal cancer: is there an association with treatment approach?
Ann Surg Oncol 2020 Oct;27(11):4443-56. doi: 10.1245/s10434-020-08578-4..
Keywords: Cancer, Surgery, Quality Measures, Quality of Care, Quality Improvement
Yuce TK, Yang AD, Johnson JK
Association between implementing comprehensive learning collaborative strategies in a statewide collaborative and changes in hospital safety culture.
Hospital safety culture remains a critical consideration when seeking to reduce medical errors and improve quality of care. Little is known regarding whether participation in a comprehensive, multicomponent, statewide quality collaborative is associated with changes in hospital safety culture. The purpose of this study was to examine whether implementation of a comprehensive, multicomponent, statewide surgical quality improvement collaborative was associated with changes in hospital safety culture.
AHRQ-funded; HS024516.
Citation: Yuce TK, Yang AD, Johnson JK .
Association between implementing comprehensive learning collaborative strategies in a statewide collaborative and changes in hospital safety culture.
JAMA Surg 2020 Oct;155(10):934-40. doi: 10.1001/jamasurg.2020.2842..
Keywords: Hospitals, Patient Safety, Organizational Change, Quality Improvement, Quality of Care, Implementation
Leeds IL, Jones C, DiBrito SR
Delay in emergency hernia surgery is associated with worse outcomes.
The purpose of this study was to determine if the variation in timing of urgent surgery impacts surgical outcomes. The National Surgical Quality Improvement Program (NSQIP) database was searched for emergent surgeries in 2011-2016 for abdominal hernia resulting in obstruction or gangrene by primary post-op diagnosis. Findings showed that delayed surgery was associated with increased rates of major complications, longer operative times, longer postoperative lengths of stay, increased re-operations, increased readmissions, and increased 30-day mortality. Next-day surgery and surgery delayed more than one day were associated with increased odds of a major complication.
AHRQ-funded; HS024547.
Citation: Leeds IL, Jones C, DiBrito SR .
Delay in emergency hernia surgery is associated with worse outcomes.
Surg Endosc 2020 Oct;34(10):4562-73. doi: 10.1007/s00464-019-07245-4..
Keywords: Surgery, Quality Improvement, Quality of Care, Critical Care, Access to Care, Digestive Disease and Health, Outcomes